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80 Cards in this Set
- Front
- Back
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What is the most important factor in electrolyte movement?
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concentration gradient
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Where is the SA and AV nodes located?
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atrium
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What is the pacemaker of the heart?
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SA node
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What is rate limiting in heart conduction?
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AV node
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What is the normal sinus rate?
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60-90
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On the EKG, what is the P wave?
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atrial depolarization
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On the EKG, what is the PR interval?
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conduction through the AV node
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On the EKG, what is the QRS complex?
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ventricle depolarization
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Atrial contraction depends on what external signal?
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Ca
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The ventricle depends on what ion for depolarization?
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Na
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On the EKG, what is the ST segment?
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ventricle contraction
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What is the T wave on the EKG?
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ventricle repolarization
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What ion is ventricle repolarization dependent on?
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K leaking out of the cell
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What is the QT interval on the EKG?
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1 complete ventricular contraction
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What supplies the SA and AV nodes with blood?
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RCA- 90% of people
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The left circumflex artery supplies what portion of the heart?
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left atrium- ant. and post.
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The left marginal supplies what portion of the heart?
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lateral side of the left ventricle
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What does the left ant. descending supply?
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entire ant. wall of both ventricles and the ant. part of the septum
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What does the right marginal supply?
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ant. part of the right ventricle
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What supplies the posterior surface of right ventricle?
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RCA
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What two arteries anastomose at the apex of the heart?
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LAD and RCA
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Where is the SA nodes located?
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high in the right atrium
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What supplies the posterior of the right atrium?
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RCA
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What is the cause of 85% of MIs?
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left
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Lead 1 looks at what?
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left atrium
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Lead 2 looks at?
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right ventricle
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Lead 3 looks at?
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left ventricle
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AVR looks at?
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right atrium
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AVL looks at?
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left atrium
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AVF looks at?
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apex
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V1 sees?
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right atrium
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V2 sees?
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left atrium
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V3 sees?
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septum and anterior heart
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V4 sees?
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anterior heart and apex
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V5 sees?
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left ventricle
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V6 sees?
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left ventricle
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What are 3 things that tell you that there was a left coronary MI?
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sudden death, massive vent. arrhythmia's, heart failure
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What is the normal PR interval?
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0.2 sec
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What is seen on the EKG with 1st degree heart block?
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fixed and prolonged PR interval
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Where is the problem with a 1st degree heart block?
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SA node or between the SA and AV node
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What will make the heart block disappear?
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exercise (speeding up the heart)
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What are the 2 kinds of 2nd degree heart block?
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Mobitz 1 and Mobitz 2
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In Mobitz 1, what do you see on the EKG?
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progressing lengthening of the PR until a QRS is dropped
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What is the problem in Mobitz 1?
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early ischemia at the AV
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What is the treatment for Mobitz 1?
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if symptomatic, put in a pacemaker, if asymptomatic, do nothing
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What does Mobitz 2 looks like on the EKG?
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PR interval is normal, but QRS complexes are erratically dropped
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What is the problem in Mobitz 2?
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late ischemia in the AV node
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What is the treatment for mobitz 2?
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all must have a pacemaker
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What does 3rd degree heart block look like on the EKG?
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P waves and QRS have no relationship
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What is the problem with 3rd degree heart block?
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AV node has completely infarcted
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What is the treatment for 3rd degree heart block?
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all must have a pacemaker
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What is a PVC?
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premature ventricular complex
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What causes a PVC?
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an ectopic firing site in the ventricle
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What does a PVC look like on an EKG?
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no P wave, wide QRS with a pause following it
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What are the 2 requirements to be diagnosed with ventricular tachycardia?
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3 or more consecutive PVC's with a heart rate above 150
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How do you recognize v-fib on the EKG?
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no recognizable QRS complexes
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What is the treatment for ventricular tachycardia if the patient is stable?
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medication
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What is the treatment for ventricular tachycardia if the patient is unstable?
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shock with 200, then lidocaine, then 300, lidocaine, then 360 and lidocaine
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What does the lidocaine do?
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takes away Na
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If shocking doesn't work, what do you give the patient?
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bretylium or amiodorone- takes the K+ away
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What do you do first to treat v-fib?
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epinephrine
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What do you see on the EKG with atrial fibrillation?
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saw tooth
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With multifocal atrial tachycardia, what will you see on the EKG?
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multiple P waves
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What will you see on the EKG with atrial fib?
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saw tooth and erratic QRS
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Regarding depolarization, is hypermagnesemia more of less likely to depolarize? Why?
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less likely- gets in the way of sodium
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What is the treatment for hypermagnesemia?
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IV normal saline and a loop diuretic
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Regarding depolarization, is hypomagnesemia more of less likely to depolarize? Why?
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more likely- less competition with Na
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What is the treatment for hypomagnesemia?
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magnesium sulphate
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Regarding depolarization, is hypercalcemia more or less likely to depolarize? Why? In smooth muscle?
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less likely, except the atrium (more likely)- Ca competing with Na
In smooth muscle, initially less, the more likely to contract due to second messenger |
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What is the treatment for hypercalcemia? Drugs?
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IV normal saline and loop diuretics, and mythromycin- pulls Ca out in stool
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Regarding depolarization, is hypercalcemia more of less likely to depolarize? Why? In smooth muscle?
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more likely to depolarize, except the atrium- smooth muscle initially more likely, then less likely
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Regarding depolarization, is hyperkalemia more or less likely to depolarize? Why?
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initially more- K will flow into the cell making the potential more positive and closer to threshold
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After the initial effect, what happens in hyperkalemia?
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K gets trapped inside the cell during repolarization and repolarization takes longer making the cell less likely to depolarize
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What would you see on the EKG with hyperkalemia?
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peaked and widened T waves and a prolonged QT interval
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What is the 4 drugs to treat hyperkalemia?
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Ca-gluconate- to keep the SA firing
insulin- to pull K into other cells bicarb- to make the kidneys waste K Kayexalate- to make you poop out K |
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Regarding depolarization, is hypokalemia more of less likely to depolarize? Why?
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less likely- K will rush out of the cells making them more negative
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What will hypokalemia look like on the EKG?
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narrow T waves, flat T waves, flipped and inverted T waves and or a U wave
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What are the 2 signs you have low Ca?
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Chuoslek- tap TMJ and the jaw opens
Trousseau- radial nerve stroke and the fist closes |
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Regarding depolarization, is hypernatremia more of less likely to depolarize? Why?
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more likely- Na rushes into cells making them more positive
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Regarding depolarization, is hyponatremia more of less likely to depolarize? Why?
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less likely- Na will leak out of the cell by Na-K exchange
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